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Observational Study
. 2025 Apr 7;25(1):266.
doi: 10.1186/s12872-025-04699-4.

Global trends and regional disparities in atrial fibrillation and flutter burden attributable to high alcohol consumption: findings from the global burden of disease study 2021

Yunkai Hua  1 , Jinpeng Liu  2 , Kui Ji  3 , Wenjun Han  4
Affiliations
Observational Study

Global trends and regional disparities in atrial fibrillation and flutter burden attributable to high alcohol consumption: findings from the global burden of disease study 2021

Yunkai Hua et al. BMC Cardiovasc Disord. .

Abstract

Objectives: To evaluate the global burden of atrial fibrillation (AF) and atrial flutter (AFL) attributable to high alcohol consumption (HAC) from 1990 to 2021, and to examine its spatiotemporal distribution characteristics.

Study design: An observational study based on Global Burden of Disease Study (GBD) 2021 data.

Methods: Using GBD 2021 data, we analyzed trends in disability-adjusted life years (DALYs) and mortality for AF/AFL attributable to HAC at the global, regional, and national levels from 1990 to 2021, with a focus on differences by gender, age, and socio-demographic index (SDI).

Results: DALYs for HAC-attributable AF/AFL rose from 155,703 (95% UI: 105,255-206,083) in 1990 to 362,698 (95% UI: 263,321-465,594) in 2021, while mortality increased from 4,308 (95% UI: 3,000-5,597) to 11,908 (95% UI: 7,826-30,753). Males and individuals aged ≥ 60 years experienced the highest burdens. Australasia recorded the highest DALYs and mortality in 2021, while South Asia showed the steepest increases, with EAPCs of 2.95 and 4.18, respectively. Higher SDI regions showed greater burdens, peaking at an SDI of 0.8 before declining.

Conclusions: HAC contributes significantly to the global AF/AFL burden, with marked regional and demographic disparities. Targeted interventions are urgently needed to address this growing public health challenge.

Keywords: Atrial fibrillation and atrial flutter; Global burden of disease; High alcohol consumption.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The GBD study’s protocol has been approved by the research ethics board at the University of Washington (UW). The GBD studies must be conducted in full compliance with UW policies and procedures, as well as applicable federal, state, and local laws. Therefore, all ethical standards are justified by properly citing the respective sources ( http://ghdx.healthdata.org/gbd-results-tool ). Consequently, ethical approval and consent procedure are not required for this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Clinical trial number: Not applicable.

Figures

Fig. 1
Fig. 1
Global burden of atrial fibrillation and atrial flutter attributable to high alcohol consumption from 1990 to 2021. (A) Numbers and ASRs (per 100,000) of DALYs. (B) Numbers and ASRs of mortality. Error bars and shaded regions indicate 95% uncertainty intervals. DALYs: disability-adjusted life years; ASR: age-standardized rate
Fig. 2
Fig. 2
Age-specific burden of atrial fibrillation and atrial flutter attributable to high alcohol consumption for males and females in 2021. DALYs rates for males and females across different age groups in 2021(A and C). mortality rates for males and females across different age groups in 2021(B and D). DALYs: disability-adjusted life years
Fig. 3
Fig. 3
Estimated annual percentage changes in age-standardized rates of DALYs and mortality for atrial fibrillation and atrial flutter attributable to high alcohol consumption across 21 regions from 1990 to 2021
Fig. 4
Fig. 4
National age-standardized rates of DALYs and mortality for atrial fibrillation and atrial flutter attributable to high alcohol consumption and their estimated annual percentage changes from 1990 to 2021. (A) National age-standardized DALYs rates and their estimated annual percentage changes. (B) National age-standardized mortality rates and their estimated annual percentage changes. DALYs: disability-adjusted life years; ASR: age-standardized rate; EAPC: estimated annual percentage change
Fig. 5
Fig. 5
SDI-based age-standardized rates of DALYs and mortality for atrial fibrillation and atrial flutter attributable to high alcohol consumption. (A) SDI-based age-standardized DALYs rates in 21 regions from1990 to 2021. (B) SDI-based age-standardized mortality rates in 21 regions from1990 to 2021. (C) SDI-based age-standardized DALYs rates across countries in 2021. (D) SDI-based age-standardized mortality rates across countries in 2021. SDI: Socio-demographic Index; DALYs: disability-adjusted life years; ASR: age-standardized rate
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References

    1. Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, Boriani G, Castella M, Dan GA, Dilaveris PE, et al.: 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European association for Cardio-Thoracic surgery (EACTS): the task force for the diagnosis and management of atrial fibrillation of the European society of cardiology (ESC) developed with the special contribution of the European heart rhythm association (EHRA) of the ESC. Eur Heart J. 2021;42(5):373–498. - PubMed
    1. Ruddox V, Sandven I, Munkhaugen J, Skattebu J, Edvardsen T, Otterstad JE. Atrial fibrillation and the risk for myocardial infarction, all-cause mortality and heart failure: A systematic review and meta-analysis. Eur J Prev Cardiol. 2017;24(14):1555–66. - PMC - PubMed
    1. Manolis AS, Manolis TA, Manolis AA, Melita H. Atrial fibrillation-induced tachycardiomyopathy and heart failure: an underappreciated and elusive condition. Heart Fail Rev. 2022;27(6):2119–35. - PubMed
    1. Wijesurendra RS, Liu A, Eichhorn C, Ariga R, Levelt E, Clarke WT, Rodgers CT, Karamitsos TD, Bashir Y, Ginks M, et al. Lone atrial fibrillation is associated with impaired left ventricular energetics that persists despite successful catheter ablation. Circulation. 2016;134(15):1068–81. - PMC - PubMed
    1. Dong XJ, Wang BB, Hou FF, Jiao Y, Li HW, Lv SP, Li FH. Global burden of atrial fibrillation/atrial flutter and its attributable risk factors from 1990 to 2019. Europace: European pacing, arrhythmias, and cardiac electrophysiology: journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2023, 25(3):793–803. - PMC - PubMed

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